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S071 Is There a Role for FDG-PET/CT in Cytologically Indeterminate Thyroid Nodules?

S071 Is There a Role for FDG-PET/CT in Cytologically Indeterminate Thyroid Nodules? Objective: To determine the accuracy of the fluorodeoxyglucose F18–positron emission tomography/computed tomography (FDG-PET/CT) scan in the evaluation of thyroid nodules in which fine-needle aspiration (FNA) cytopathology is classified as “indeterminate,” ie, either follicular or Hürthle cell lesion. Methods: At an academic medical center, we conducted a prospective, pilot study of 15 patients with thyroid nodules in whom adequate FNA was diagnosed as “indeterminate.” All patients underwent a whole-body FDG-PET/CT scan followed by thyroidectomy. Preoperative FDG-PET/CT results and the histopathology of the surgical specimen were compared and statistically analyzed. Results: FNA demonstrated follicular cells in 11 patients (73%), Hürthle cells in 2 patients (13%), and both cell types in 2 patients (13%). Histopathology of the surgical specimen revealed thyroid cancer in 7 patients (47%). The FDG-PET/CT scan was positive in 7 patients; 4 (57%) were found to have cancer. The FDG-PET/CT scan was negative in 8 patients. Five of these patients had benign lesions and 3 had thyroid carcinoma. Thus, 3 patients (20%) had false-positive FDG-PET/CT scans, and 3 patients (20%) had false-negative studies. The sensitivity of FDG-PET/CT to detect a malignant focus was 57% with a specificity of 63%. The positive and negative predictive values were 57% and 63%, respectively. Conclusions: In this pilot study of patients with cytologically indeterminate thyroid nodules, FDG-PET/CT was not a predictable indicator of benign or malignant disease. While a larger series may elucidate a role for FDG-PET/CT, the relatively low predictability shown in this study should caution clinicians about utilizing FDG-PET/CT to consider forgoing thyroidectomy for cytologically indeterminate nodules. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

S071 Is There a Role for FDG-PET/CT in Cytologically Indeterminate Thyroid Nodules?

S071 Is There a Role for FDG-PET/CT in Cytologically Indeterminate Thyroid Nodules?

Abstract

Objective: To determine the accuracy of the fluorodeoxyglucose F18–positron emission tomography/computed tomography (FDG-PET/CT) scan in the evaluation of thyroid nodules in which fine-needle aspiration (FNA) cytopathology is classified as “indeterminate,” ie, either follicular or Hürthle cell lesion. Methods: At an academic medical center, we conducted a prospective, pilot study of 15 patients with thyroid nodules in whom adequate FNA was diagnosed as...
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Publisher
American Medical Association
Copyright
Copyright © 2006 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.132.8.854-b
Publisher site
See Article on Publisher Site

Abstract

Objective: To determine the accuracy of the fluorodeoxyglucose F18–positron emission tomography/computed tomography (FDG-PET/CT) scan in the evaluation of thyroid nodules in which fine-needle aspiration (FNA) cytopathology is classified as “indeterminate,” ie, either follicular or Hürthle cell lesion. Methods: At an academic medical center, we conducted a prospective, pilot study of 15 patients with thyroid nodules in whom adequate FNA was diagnosed as “indeterminate.” All patients underwent a whole-body FDG-PET/CT scan followed by thyroidectomy. Preoperative FDG-PET/CT results and the histopathology of the surgical specimen were compared and statistically analyzed. Results: FNA demonstrated follicular cells in 11 patients (73%), Hürthle cells in 2 patients (13%), and both cell types in 2 patients (13%). Histopathology of the surgical specimen revealed thyroid cancer in 7 patients (47%). The FDG-PET/CT scan was positive in 7 patients; 4 (57%) were found to have cancer. The FDG-PET/CT scan was negative in 8 patients. Five of these patients had benign lesions and 3 had thyroid carcinoma. Thus, 3 patients (20%) had false-positive FDG-PET/CT scans, and 3 patients (20%) had false-negative studies. The sensitivity of FDG-PET/CT to detect a malignant focus was 57% with a specificity of 63%. The positive and negative predictive values were 57% and 63%, respectively. Conclusions: In this pilot study of patients with cytologically indeterminate thyroid nodules, FDG-PET/CT was not a predictable indicator of benign or malignant disease. While a larger series may elucidate a role for FDG-PET/CT, the relatively low predictability shown in this study should caution clinicians about utilizing FDG-PET/CT to consider forgoing thyroidectomy for cytologically indeterminate nodules.

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Aug 1, 2006

Keywords: thyroid nodule,fluorodeoxyglucose positron emission tomography

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